Pattern of Antimicrobial Resistance in Clinical Isolates of Acinetobacter Species Isolated from Intensive Care Unit Patient’s Sample at a Tertiary Care Hospital in North India

Abstract

Introduction: Acinetobacter species are one of the most
common pathogens causing hospital-acquired infections (HAIs)
and multi-drug resistant Acinetobacter isolates are a rapidly
emerging pathogen in healthcare settings and have limited
options for effective treatment. It is increasingly reported as
the cause of outbreaks and nosocomial infections such as
blood-stream infections, ventilator-associated pneumonia,
urinary tract infections and wound infections. To determine the
antimicrobial susceptibility/resistant pattern among isolated
Acinetobacter species.
Material and Methods: A total of 140 Acinetobacter species
were isolated from various clinical specimens. The isolated
Acinetobacter species were further processed for antibiotic
susceptibility testing (AST) using the Kirby-Bauer disc diffusion
method. All Imipenem-resistant cases were further evaluated
for Metallo-β-lactamase (MBL) production using Imipenem
Ethylenediamine tetraacetic acid (EDTA) combined disc test
and modified Hodge test, two phenotypic methods. Statistical
analysis was done using Microsoft office excel 2010.
Results: The present study was carried out for one and a half
years from 1st January 2013 to June 2014 in the microbiology
department on the samples received from the intensive care
unit (ICU) of SRMS-IMS Bareilly. During this period total of
140 Acinetobacter species were isolated. The majority were
isolated from respiratory samples, followed by urine, pus and
blood. Acinetobacter isolates were found to be resistant to most
of the commonly used antibiotics. Antimicrobial susceptibility
testing showed the highest resistance to cefepime 5/140
(96.43%), ceftazidime 6/140 (95.72%), levofloxacin 8/140
(94.29%), amikacin 9/140 (93.58%) and highest sensitivity
135/140 (96.42%) to polymyxin and colistin 132/140 (94.28%).
72/83 (86.7%) and 62/83 (74.7%) Acinetobacter species show
metallo-β-lactamase (MBL) production by Imipenem-EDTA
combined disc test and modified Hodge test, respectively.
Conclusion: The increasing trends towards antibiotic
resistance reflect the extensive use of antibiotics in hospitals
which in turn exerts selective pressure on Acinetobacter in
the hospital environment. Therefore, surveillance is needed
to detect multi-drug resistant (MDR) Acinetobacter species,
judicious use of antibiotics and implement appropriate infection
control measures to control the spread of these MDR strains
in hospitals.